CN103536353A - Compressable catheter tip with image-based force sensing - Google Patents

Compressable catheter tip with image-based force sensing Download PDF

Info

Publication number
CN103536353A
CN103536353A CN201310292907.5A CN201310292907A CN103536353A CN 103536353 A CN103536353 A CN 103536353A CN 201310292907 A CN201310292907 A CN 201310292907A CN 103536353 A CN103536353 A CN 103536353A
Authority
CN
China
Prior art keywords
labelling
tip
conduit
catheter tip
guidance system
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN201310292907.5A
Other languages
Chinese (zh)
Other versions
CN103536353B (en
Inventor
G.A.梅雷迪思
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Siemens AG
Siemens Corp
Original Assignee
Siemens AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Siemens AG filed Critical Siemens AG
Publication of CN103536353A publication Critical patent/CN103536353A/en
Application granted granted Critical
Publication of CN103536353B publication Critical patent/CN103536353B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves  involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
    • A61B5/064—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6885—Monitoring or controlling sensor contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0127—Magnetic means; Magnetic markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2051—Electromagnetic tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/374—NMR or MRI
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M2025/0166—Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/0069—Tip not integral with tube
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable

Abstract

A catheter (10) comprising a catheter tip (14) that is adapted to have deflection of an associated spring (22) detected by imaging techniques and to have that deflection be translated into an estimation of the tip (14) contact force.

Description

The compressible catheter tip with the power sensing based on image
Technical field
The present invention relates generally to conduit, and relates more specifically to the conduit for ablative surgery.
Background technology
Conduit is the medical apparatus of hollow flexible tube form, and it is for inserting a part for health, conventionally allow fluid by or keep path to open.Conduit generally depends on that application is with Accessory Members, as joystick, catheter tip, operation tool etc. (and therefore can be more suitable for being called generally conduit system).In Wicresoft's medical surgery, conduit is generally used for delivering therapeutic in one way, makes to need corresponding catheter tip to contact with tissue to be treated.The example that radio-frequency (RF) ablation (RFA) is this type of operation, wherein utilizes the cuspidated ablation catheter of tool to carry out treatment, and the most advanced and sophisticated high-frequency alternating electric current of carrying, to cause the heating of tissue.
Although some RFA operations relate to, ablation tip is placed in tissue to be treated, as in the treatment of tumor, other only relates to makes directly contact tissue surface of ablation tip, as in ARR treatment.In the operation of latter a type, on contact tissue surface and not penetrate tissue in the situation that, the success of operation partly depends on how to make effectively contact tissue surface of ablation tip only, tip.If tip does not contact well with tissue surface, heat to treat and will weaken.If with only contact surface is contrary lightly, utilize some power to make effectively contact tissue surface, tip, heat to treat more effective.
In the situation that the RFA operation in cardiophysiology (EP), target is to make RFA tissue to be heated to the point that causes damage, and this will stop some electric pathway contributing in ARR heart tissue.Therefore, ablation tip is very important in the success for the treatment of to the exposure level of tissue.In order effectively to stop the signal of telecommunication, damage should have certain depth in tissue, this be only formed on the thin layer of tissue surface in contrary.The degree of depth of damage depends on supplies with most advanced and sophisticated contact force and ablation power.If do not form the damage of enough degree of depth and area due to not enough contact and/or power, RFA operation will be tending towards more of a specified duration, and perform the operation to have and highlyer may will can successfully not stop arrhythmia, make the follow-up operation of needs.On the contrary, if there is excessive power and/or excessive power, exist and comprise penetrate tissue wall, esophagus injury, due to steam ejection, (this name by Y. Yang is called " Atrial Fibrillation Ablation to the potential risk (particularly during the flushing ablative surgery under high power) of cardiac tamponade or perforation, The emerging role of the stereotaxis " (Davis of University of California medical centre, internal medicine, cardiovascular medicine portion, 2011, http://www.ucdmc.ucdavis.edu/internalmedicine/ cardio/pdf/atrial%20fibrillation%20ablation%202011.pdf) in statement, further mentioned in detail).Therefore, successfully heart RFA treatment attempts to form effective damage, still reduces to greatest extent the risk of complication simultaneously.Both depend on and control the exposure level of ablation tip to tissue.
RFA operation is normally carried out under image guiding (normally cryptoscope or ultrasound wave).Although image guidance system and technology can provide the visual of catheter tip, and sometimes provide the associated of physical location that most advanced and sophisticated location in some coordinate spaces, challenge be this tip information and relevant anatomy tissue conventionally.Sometimes, this can be by realizing by optimal imaging plane, and optimal imaging plane clearly show that anatomical tissue and install both, but this is very difficult in as heart at complicated anatomical tissue.The in the situation that of heart, this is further complicated by heartbeat, patient respiratory motion and catheter movement.Other technology relates to the volume imagery data or the 3D model that obtain in advance that uses the anatomical tissue that is superimposed with realtime imaging, but these also can have mistake owing to coming from the alignment error of local motion and coming from more overall patient's transfer.Therefore, use individually imaging technique, may be difficult to judge definitely whether ablation tip well or suitably contacts with tissue surface.
In current practice, exist assessment whether to complete in some cases some measures of well melting.Although user has some resistances sensation when conduit is guided towards target anatomical tissue, once at target place, for user, conventionally by do not exist enough sensitivity inform between ablation tip and tissue surface contacted how good.For measuring a lot of conduit systems of most advanced and sophisticated contact force and the sensor that method relies on some forms that are building up to tip, as optical fiber force transducer, piezoelectric strain gauge or other such device.Some systems are forwarded back to signal (signal of telecommunication, optical signal or the signal based on fluid) the manual product of conduit, power corresponding to this signal convert to, to attempt giving user by more real tactile feedback.Other system provides quantitative measurement, and quantitative measurement can show to contribute to measure to user the power of most advanced and sophisticated contact.
In cardiac EP system, conduit also has the electrode of the electrical impedance of measuring heart tissue, and electrical impedance is as for planning ablation locations and also for checking a part for the mapping function of the perioperative variation of RFA.Damage forms by tissue impedance and the important relationship that is delivered between the power of ablation tip to be affected.Tissue impedance's measured value also can provide some indications of most advanced and sophisticated contact because most advanced and sophisticated when organizing good contact, impedance will increase.
Aspect the most advanced and sophisticated contact force of actual catheter, various research makes their result characterization with varying level.Although come from the viewpoint of heart, but statement and K. Yokoyama by Yang mentioned above, H. Nakagawa, D.C. the people's such as Shah name is called " Novel Contact Force Sensor Incorporated in Irrigated Radiofrequency Ablation Catheter Predicts Lesion Size and Incidence of Steam Pop and Thrombus " (Circulation:Arrhythmia and Electrophysiology, 2008, 354 to 362 pages, the 1st volume, American Heart Association) paper provides some Common Criteria.The example of the force level of characterization can be described as following:
The low contact force of < 10g to 15g, it is invalid to melt
The medium contact force of 20g to 25g
> 40g to 60g high contact force
> 100g has the risk of heart tissue perforation.
Yet with respect to heart RFA application, when attempting to realize best damage, most advanced and sophisticated contact force must be considered with power, impedance together with temperature.The persistent period of particular ablation, for damage another key factor in forming, has wherein been used various technology, and scope continues to melt to long from the short septal ablation of point independently, and wherein tip can be dragged one minute or longer on region.In this regard, the concordance of most advanced and sophisticated contact force is another key factor.
Several companies have the power sensing ablation catheter in clinical trial at present, comprise the TactiCath that comes from Endosense and the Thermocool Smarttouch that comes from Biosense Webster.TactiCath is used based on fibre-optic force transducer.SmartTouch is used the force transducer based on magnetic signal.These conduits are not compatible with nuclear magnetic resonance (MRI), but their uses in various research and clinical trial provide the evidence of the clinical advantages with power sensing function, (people's such as this paper at Yokoyama mentioned above and B. Schmidt name is called " TOCCATA Multi-Center Clinical Study:Irrigated RF Ablation Catheter with an Integrated Contact Force Sensor-Long-term Results " (Heart Rhythm 2010, 2010, PO2-59, Heart Rhythm Society) in paper, describe in further detail).For example, carry out the ability of RFA operation by being desired for strengthening image guiding under MRI, because except other reason, MRI provides the excellent soft tissue contrast in image, and in 3d space the ability of follow-up mechanism.At King's College London, carrying out the research of the power sensing tube that MRI is compatible, it uses, and based on fibre-optic power sensing, (this is at P. Polygerinos, A. Ataollahi, the people's such as T Schaeffter name is called " MRI-Compatible Intensity-Modulated Force Sensor for Cardiac Catheterization Procedures " (IEEE Transactions on Biomedical Engineering, in March, 2011,58 (3), 721 to 726 pages) paper in described in more detail).Diverse power sensing approach provides in the long-range magnetic navigation system of stereotaxis (having described in the statement of Yang mentioned above), and this system advocates that " soft and consistent tissue contact " is as an one advantage.Although control conduit with Magnet, move, this system is not that MRI is compatible, but is conventionally combined with fluoroscopic systems.
In the compatible ablation catheter field of MRI, also studying, for example, the MRI Interventions cooperating with Siemens (being SurgiVision in the past); Philips; The Imricor cooperating with GE; And Ge research institution place, but all these researchs are still in front clinical stage.These researchs are not all openly mentioned power sensing function as a part for the compatible conduit work of its MRI.The challenge that conduit MRI is compatible is increased the weight of by required a plurality of functions (measurement of the conveying of ablation energy, the measurement of impedance, tracking coil signal etc.).Although power sensing tip will provide clinical advantages, in the compatible conduit of MRI, add this ability and will further make to design complicated.
Summary of the invention
The present invention has eliminated above problem by a kind of conduit is provided, this conduit comprises the compressible catheter tip with a plurality of labellings, labelling is suitable for allowing the image guidance system being associated to follow the trail of labelling, to obtain the positional information of labelling, and estimates most advanced and sophisticated contact force from positional information.Labelling can be suitable for allowing the image guidance system being associated to measure most advanced and sophisticated deflection, for estimating most advanced and sophisticated contact force.As alternative, compressible catheter tip also can have the Compress Spring being combined in wherein, and most advanced and sophisticated contact force is estimated in the deflection that labelling can be suitable for allowing the image guidance system that is associated to measure Compress Spring.
Labelling can comprise the magnetic resonance tracking coil being attached in most advanced and sophisticated structure.As alternative, labelling can comprise the magnetic resonance tracking coil being attached in most advanced and sophisticated structure, and image guidance system can be carried out the 3D positional information that nuclear magnetic resonance carrys out tracking coil and obtains coil.Labelling also can comprise the passive marker on most advanced and sophisticated outer surface.As alternative, labelling can comprise the passive marker on most advanced and sophisticated outer surface, and image guidance system can be carried out the 2D positional information that projection imaging is followed the trail of labelling and obtained labelling.
The present invention also provides the system of a kind of uniting conduit system and image guidance system, it comprises the compressible catheter tip with a plurality of labellings, labelling provides the location of catheter tip to come for visual and navigation by imaging guidance system, and by imaging guidance system, provides the measurement of deflection of catheter tip for estimating most advanced and sophisticated contact force.Labelling can comprise the magnetic resonance tracking coil by the structure combination of catheter tip, and image guidance system can comprise magnetic resonance imaging system.As alternative, compressible catheter tip can comprise and is connected to slidably two sections going up each other and have respectively magnetic resonance tracking coil, and be connected to two Compress Springs between section, and image guidance system can be derived 3D coordinate to determine two distances between coil and to estimate most advanced and sophisticated contact force from the decrement of spring from tracking coil signal.
Labelling also can comprise the passive marker on the outside of catheter tip, and image guidance system is carried out projection imaging.As alternative, compressible catheter tip can comprise and is connected to slidably two sections going up each other and have respectively corresponding lip-deep at least one passive marker, and be connected to two Compress Springs between section, and image guidance system can be derived 2D coordinate to determine two distances between labelling from passive marker, and estimates most advanced and sophisticated contact force from the decrement of spring.As alternative, compressible catheter tip can comprise and is connected to slidably two sections going up each other, section has the passive marker in respective surfaces and another section has at least two passive markers in respective surfaces, and be connected to two Compress Springs between section, and image guidance system can be derived 2D coordinate from passive marker and determine a labelling section and the distance between the labelling on another section, and estimates most advanced and sophisticated contact force from the decrement of spring.In the case, at least two passive markers on another section can have accordingly between corresponding fixing and predetermined distance.
The present invention also provides the method for a kind of measuring guide contact force that tip applies against destination object, is included in catheter tip operating period to derive each the corresponding position coordinates in a plurality of labellings on catheter tip; In the operating period of catheter tip, determine the corresponding distance between labelling; And calculating the most advanced and sophisticated contact force against destination object, described conduit is suitable for providing the variable range between at least two in a plurality of labellings in catheter tip operating period.Conduit can be included in catheter tip operating period provides the Compress Spring being associated of the described variable range between at least two in a plurality of labellings, and then calculation procedure can comprise based on spring property and calculate the most advanced and sophisticated contact force against destination object.Derivation step can comprise from the real-time positioning of the nuclear magnetic resonance of catheter tip and labelling and the visual 3D coordinate that obtains each labelling a plurality of labellings.As alternative, derivation step can comprise from the real-time positioning of the projection imaging of catheter tip and labelling and the visual corresponding 2D coordinate that obtains each labelling a plurality of labellings.
The present invention also provides a kind of method of magnetic resonance (MR) imaging guiding of medical science intervene operation, comprise the MR tracking coil of positioning combination in the conduit for corresponding operation, and during the MR image viewing of the patient's anatomical tissue under checking from the power at locating information measuring guide tip.Conduit can be suitable for providing the variable distance between at least two MR tracking coils at corresponding intra-operative.The method of MR imaging guiding also can comprise to corresponding operation power measured value is provided, and it is in conjunction with the information of the credibility about locating information, to give the indication of the accuracy of the measured value of exerting oneself.
Accompanying drawing explanation
In order to understand better the present invention, will the description of following exemplary embodiment and accompanying drawing be carried out to reference, in the accompanying drawings:
Fig. 1 is the diagram of the cross section of conduit constructed according to the invention;
Fig. 2 is another diagram of the cross section in Fig. 1;
Fig. 3 is for being combined with the conduit in Fig. 1 of the MRI system that power sensing function (simplification) is provided;
Fig. 4 is according to the block diagram of the operation of the system of the combination in Fig. 3 of the present invention; And
Fig. 5 is the diagram of the cross section of the second conduit constructed according to the invention.
The specific embodiment
Fig. 1 is the diagram that comprises the conduit 10 of the catheter shaft 12 that forms flexible hollow tube.For example, axle 12 can consist of flexible polymer property management (as Pebax board) or any other material that can be used for medical application.Conduit 10 also comprises compressible catheter tip 14, and catheter tip 14 is attached on the end of the axle 12 being inserted in patient body.Most advanced and sophisticated 14 have two primary section, for example, comprise the rigidity distal tip section 16 of ablation tip, and be fixed to the rigidity proximal tips section 18 on catheter shaft 12.Two sections 16,18 are followed the shape of axle 12 substantially, and are substantially tubulose.In addition, two sections 16,18 are constructed and are sized to so that distal tip section 16 interlocks with proximal tips section 18, and distal tip section 16 is suitable on proximal tips section 18, being free to slide back and forth in certain limitation.For example, proximal tips section 18 axle 12 through and be coupled to securely the hollow space of proximal tips section 18 in by means of binding agent, be fixed on axle 12 simultaneously, make most advanced and sophisticated 14 can not remove from axle 12.For example, two sections 16,18 can consist of rigid polymer or other material that can be used for medical application.
The interlocking of two sections 16,18 can be in a number of ways design by two elements realize.Fig. 1 has specifically illustrated and has formed the distal tip section 16 that is slightly greater than proximal tips section 18.Also shown is the far-end of the proximal tips section 18 with conical lip 18a, it provides interlock to coordinate when proximal tips section 18 is assembled in distal tip section 16, and distal tip section 16 has the corresponding conical sleeve 16a in its proximal end.Once interlock coordinates, make to assemble, section 16,18 will can not be applied on distal tip section 16 and depart under any normal forces away from proximal tips section 18 in expectation in the expection application of conduit 10.
Conduit 10 also comprises Compress Spring 22, it is arranged in distal tip section 16, the first end of the proximal end of tool distal tip section 16, the far-end of contact proximal tips section 18, and the second end of the end relative with the near-end of distal tip section 16, the inner side end wall of contact distal tip section 16.Spring 22 is installed in one way, and spring 22 is become against proximal tips section 18 by compression when power is applied on most advanced and sophisticated 14, causes that distal tip section 16 moves towards proximal tips section 18 along slip axis or longitudinal axis.Note, (proximal tips section 18 forms assembly together with distal tip section 16, compressible catheter tip assembly 14), it changes length by the degree that depends on deflection, extension or compression (on its y direction), but has aspect the minimum bend of its longitudinal axis and will remain rigidity.
Distal tip section 16 and proximal tips section 18 can have respectively the micro-coil C1 of the RF being attached in its corresponding outer wall, C2.As shown in fig. 1, micro-coil C1, C2 can be configured to annular or general toroidal.Yet, more extensive, each micro-coil C1, C2 all can be configured to follow substantially the shape of the lateral wall of corresponding section 16,18.In addition, in some cases, each section 16,18 all can have more than one micro-coil.As will be described in more detail, micro-coil C1, C2 act as the tracker of catheter tip 14 during image guiding, and makes it possible to by most advanced and sophisticated 14 sensing power.Note, axle 12 can comprise other tracking coil along its length conventionally, but these will can not make it possible to as micro-coil C1, such sensing power that C2 is possible.Be also noted that, most advanced and sophisticated 14 can comprise other member (not shown for the ease of observation), as the electrode for ablation catheter.
Fig. 1 shows at it compressible spring 22 of " original position state ",, at most advanced and sophisticated 14 places, there is no contact force F that is.Fig. 2 shows the compressible spring 22 in its " most compressed state ",, has the contact force F that causes that spring 22 compresses completely at most advanced and sophisticated 14 places that is.Yet, to note, spring 22 is installed in one way, even if make spring 22 when its " original position state ", in spring 22, will have some deflections, power is applied on distal tip section 16 away from detecting most advanced and sophisticated section 18.This deflection will make distal tip section 16 move to vertically the point that conical lip on proximal tips section 18 is caught the corresponding sleeve on the inner side of distal tip section 16.This design has guaranteed that two sections 16,18 are held in place securely at " the original position state " of spring 22, wherein in this " original position state ", and two micro-coil C1, the distance between C2 is fixed.
Note, spring constant k will make spring 22 will be equivalent to best most advanced and sophisticated contact force (for example, under power 25g) at the mid point of its range of deflection or compression zone, and spring 22 by be recognized as excessive power (for example, 75g) under in its maximum compression.Be also noted that, compressible most advanced and sophisticated 14 multi-form different springs 22 and/or the different spring constant of utilizing produces, to optimize deflection feature in can applying some application of greater or lesser power and performing the operation.
Fig. 3 is the simplification diagram of conduit 10 (as ablation catheter), and conduit 10 provides the power sensing function with image guidance system 40 combinations.Advantageously, it is compatible that conduit 10 is also suitable for MRI, so image guidance system 40 can be magnetic resonance imaging system.As described above, conduit 10 comprises catheter shaft 12, compressible most advanced and sophisticated 14 and joystick 20.
MRI system 40 comprises magnetic resonance (MR) scanner 42, and it has main magnet 42a, gradient coil system 42b and RF system 42c.Main magnet 42 generates stronger magnetostatic field in imaging region, and subject (that is, patient) is introduced in imaging region to make the atom polarization of the target tissue region under inspection.Gradient coil system 42b generates along the time dependent linear magnetic field gradient of corresponding direction in space x, y and z, and space encoding is carried out in the position of the atom of polarization or excitation.RF system 42c to target tissue region, to stimulate the atom of " in order ", and also can be suitable for a series of RF burst transmissions switching between transmission mode and receiver mode.
MRI system 40 also comprises control piece or the computer system 44 with measurement and reconstruction processor 44a and control processor 44b.Computer system 44 is controlled the operation of MR scanner 42 and member thereof by control processor 44b, and specifically coordinates various members to carry out desired MR pattern pulse sequence.MR scanner 42 repeats the certain number of times of MR pattern pulse sequence, so during the foment causing at the energy by RF pulse, atom is around orientation (along the main field) vibration of polarization.In resonance or the duration of oscillation with when atom is got back to its corresponding arrangement, atom discharges RF energy,, generates RF signal that is.RF system 42c receives or surveys the RF energy discharging, and the MR signal of encoding to computer system 44 spans.By measurement and reconstruction processor 44a, carry out applicable algorithm for reconstructing, (the vision that computer system 40 processing MR signals are transformed into target tissue region by them presents, the MR image of rebuilding), for demonstration, storage, image, process and/or other purposes.
Conduit 10 is operably connected in MRI system 40.For example, MRI system 40 to device (is for example suitable for utilizing, real-time MR pattern pulse sequence is carried out in the support of catheter tip 14) following the trail of, followed the Dumoulin at C. L., S.P. the name of Souza and R.D. Darrow is called " Real-time position monitoring of invasive devices using magnetic resonance " (Magnetic Resonance in Medicine, 1993, 411 to 415 pages, 29 volumes) principle first proposing in paper, and this principle is also called the United States Patent (USP) 5 of " Tracking system to follow the position and orientation of a device with radiofrequency field gradients " in the name of authorizing the people such as Dumoulin, 211, in 165, described, and as finding in having expanded the nearest system of this technology, for example, as L. Pan, J. Barbot, S. the people's such as M. Shea name is called " An Integrated System for Catheter Tracking and Visualization in MR-Guided Cardiovascular Interventions " (The International Society for Magnetic Resonance in Medicine, 211, summary 195, verbal report, on March 10th, 2011) in statement, described, each in three lists of references is all incorporated herein by reference.In addition, control processor 44b provides the control of MR scanner 42, and Real-time Feedback is provided, as, ablation tip contact force measured value.To note, MRI system 40 is suitable for uniting conduit 10 operations, and for this reason, MRI system 40 can comprise applicable member, for example, and input/output device, tangible data storage media, various software, graphical user interface, network equipment etc.
Fig. 4 is that the conduit 10-MRI system 40 of combination is measured the block diagram of the operation 100 of most advanced and sophisticated contact force during intervene operation.For example, this operation can be RFA in cardiac EP operation, patient experience intervene operation wherein, and this intervene operation for example relates to ablation catheter, (, in the cardiac EP ablative surgery for the treatment of atrial fibrillation in the inner side of right atrium) near target anatomical tissue.In first step 102, the real-time vision that 40 operations of MRI system obtain target anatomical tissue and peripheral region presents.The assistance of the imaging that utilization provides, ablation catheter 10 inserts and moves forward through patient's vascular system, makes catheter tip 14 press destination organization (step 104).This causes compressible most advanced and sophisticated 14 compressions, and distal tip section 16 is moved towards proximal tips section 18, and has shortened two micro-coils or tracking coil C1 on compressible tip assembly 14, the distance between C2.
As a part for the image reconstruction of being carried out by MRI system 40, measurement and reconstruction processor 44a calculate the real-time 3D coordinate at the center of each tracking coil, comprise two tracking coil C1 on compressible tip assembly 14, C2.This trace data is sent to control processor 44b (step 106) and comes implementation capacity to calculate.Particularly, control processor 44b calculates the distance (step 108) between two micro-coil C1 in compressible tip and C2, uses following simple computation to provide each relative x, y, z coordinate, for example:
Distance=square root ((x2-x1) 2+ (y2-y1) 2+ (z2-z1) 2) .
Then, control processor 44b is used two micro-coil C1 in compressible tip, and spring constant k and the following relation of the current distance between C2 based on known is similar to by the most advanced and sophisticated 14 power F (step 110) that apply:
F?=?k?·?delta,
Wherein delta represents total spring displacement, and equals D_home-D_current +delta_initial delta; Two micro-coil C1 in " the original position state " of D_home representative when not having power to be applied to most advanced and sophisticated 14 place, the distance between C2; D_current represents two micro-coil C1, the current distance between C2; And delta_initial representative under compression not with respect to the displacement of the spring in " original position state " of spring length.
Note, above power is calculated the high accuracy of benefiting from MR tracking coil locator data.Expand the people's such as Dumoulin As mentioned above original work, for improving this accuracy, carried out various research, comprise J. Barbot, T. Wech, S. the people's such as Shea name is called " Accurate Localization of Active Devices during Interventional MR Imaging " (The International Society for Magnetic Resonance in Medicine 2011, 2011, 1747 pages) article and J. Barbot, S. Shea, K. the people's such as Kirchberg name is called " Accurate Localization of Active Devices using Multi-scale Analysis for Interventional MR Imaging " (The International Society for Magnetic Resonance in Medicine 2012, 2012, 5908 pages) article in the nearest research described, each in two lists of references is all incorporated herein by reference.
Then, MRI system 40 can present current most advanced and sophisticated contact force (step 112) to user.For example, this can be by comprising that the pictorial displays that digital reading and/or figure present completes, and pictorial displays can comprise the continuous gradient within the scope of the power of illustrating, and/or whether the power of pointing out is in minimal-contact scope, best contact range or excessive contact range.Numeral and pictorial displays also can be combined as the color gamut about the residing scope of power of additional prompt signal.If the information of the credibility of the current trace data about reporting is provided by the algorithm for reconstructing of measuring and reconstruction processor 44a carries out, this reliability information can be attached in the contact force information of presenting to user, to give the indication of the accuracy of the measured value of exerting oneself.
Therefore, the invention provides in order to measure novel conduit and the operational approach of the contact force being applied by catheter tip during intervene operation.As described above, conduit comprises catheter tip, and catheter tip has respectively two sections with RF tracking coil, and the Compress Spring between two sections.In order to measure the operational approach of contact force, comprise from tracking coil signal and derive 3D coordinate to determine two distances between coil, and then determine again the decrement (given spring constant, this is convertible into power measured value) of the spring in tip assembly.
Advantageously, utilization realizes contact force measurement with the assistance of the MRI guiding of MR trace data, and MR trace data has generated positioning catheter and catheter tip, for visual and navigation.MRI provides the overall advantage that there is no ionizing radiation and good soft-tissue imaging.Although preferably soft-tissue imaging can provide separately the image guiding of enhancing, the use with the conduit that the MRI of tracking coil is compatible provides the better visual of catheter position, makes the concept of " strengthening image guiding " further.Heart RFA operation is peculiar, and MRI may provide the imaging of damage to assess the success of melting, and this is contrary with real time imaging guiding, and aspect operation guiding, advantage is larger.This has explored in nearest research, and the name people such as McGann is called " Dark Regions of No-Reflow on Late Gadolinium Enhancement Magnetic Resonance Imaging Result in Scar Formation after Atrial Fibrillation Ablation " (J Am Coll Cardio, 2011,177-185 page, 58 volumes, No. 2) article in described.
The present invention also can provide not have the device by the micro-coil location of MR is followed the trail of to the conduit 200 of supporting.This type of conduit 200 will provide except about using the advantage of the first conduit 10 those of MRI guiding and MR trace data.The cross section of alternative conduit 200 is shown in Figure 5, and is similar to the first conduit 10 aspect its structure and operation most of.For example, be similar to the first conduit 10, alternative conduit 200 comprises catheter shaft 212, compressible catheter tip 214, tip 214 has distal tip section 216, proximal tips section 218 and is arranged on the Compress Spring 222 of distal tip section 216 inner sides, it has the first end at the far-end of the contact proximal tips section 218 of the proximal end of distal tip section 216, and at the second end of the inner side end wall of the contact distal tip section 216 of the end of the distal tip section 216 relative with its near-end.Yet distal tip section 216 or proximal tips section 218 all do not have the RF tracking coil being attached in its corresponding outer wall.As an alternative, two sections comprise the passive marker M on its corresponding outer wall that can process to detect by image.
The figure shows three labellings, the 1st labelling M1 is on compressible most advanced and sophisticated 214 distal tip section 216, and the 2nd labelling M2 and the 3rd labelling M3 are on compressible most advanced and sophisticated 214 proximal tips section 218.All three labelling M1, M2, M3 is positioned to roughly conllinear, and keeps so in 200 operating periods of system, because as described above, the assembly of two sections 216,218 keeps rigidity having aspect the minimum bend of its longitudinal axis.Labelling M1, M2, although M3 is positioned to longitudinally conllinear, can be shaped to local is annular or the local periphery (as shown in Figure) of following corresponding outer wall.It is fixing that the 2nd labelling M2 in same sector and the distance between the 3rd labelling M3 keep in any operation always.
Be similar to the first conduit 10, alternative conduit 200 can be combined with image guidance system (not shown), to measure the most advanced and sophisticated contact force during intervene operation.Image guidance system can be used projection imaging technology particularly, as the thick-layer in MR imaging or the projection of standard fluorescence mirror, for example, the angle between projection vector and catheter tip 214 axis as long as not too little (, at least 45 degree).Utilize this type of guidance system, all three labelling M1, M2, M3 will be clear that in projection, and from away from enough each other, can produce rational measurement and to derive corresponding power measured value.
For example, so projection imaging guidance system is operable to for obtaining the real-time vision of target anatomical tissue and peripheral region, present, and in order to contribute to make conduit 200 reaches through patient's vascular system to destination organization.Compressible most advanced and sophisticated 214 compress when pressing destination organization, and this makes distal tip section 216 move towards proximal tips section 218, and have reduced the 1st labelling M1 and other two labelling M2, the distance between each in M3.Even shortened most advanced and sophisticated 214 axis due to the angle between most advanced and sophisticated axis and projection vector in projected image, also can determine the actual range between the 1st labelling M1 and the 2nd labelling M2 from definite mark position corresponding 2D projected image.
This substantially can be by following realization.For any angle between most advanced and sophisticated axis and projection vector, the ratio of the distance between labelling will be identical, no matter and use actual range or use the distance of the shortening that comes from 2D projected image.Following parameter can be defined as the work for distance rates:
Da12: the current actual compression distance between the 1st labelling M1 and the 2nd labelling M2;
Da23: the fixedly actual range between the 2nd labelling M2 and the 3rd labelling M3;
Dp12: the 1st labelling M1 in 2D projection and the current distance between the 2nd labelling M2; And
Dp23: the 2nd labelling M2 in 2D projection and the current distance between the 3rd labelling M3.
Then, following distance rates can be defined as:
Da12/da23=dp12/dp23, it can be rewritten as:
da12?=?da23?·?(dp12/dp23)。
As described above, because parameter d a23 is known fixed range, therefore only need to be from the ratio of the distance of 2D projected image.
Therefore, can determine the 1st labelling M1 compressible tip assembly 214 and the current actual range between the 2nd labelling M2 from the projected image of the random angle with respect to most advanced and sophisticated axis.Two micro-coil C1 in this 3d space that is equivalent to be measured by the first conduit 10, the distance between C2.After this, the power based on spring constant is similar to/calculates can carry out with the first conduit 10 (mentioned above) identical.
In using this 2D projection imaging method of alternative conduit 200, the identification of mark position can complete by measurement and the reconstruction processor of image guidance system, or as alternative, in the additional software module of system of analyzing the 2D image producing by reconstruction, complete.Because the method can be used the different projection imaging technology except MR imaging, therefore can use various forms of reconstructions.
Note, the restriction of the alternative conduit 200 that the angle between most advanced and sophisticated axis and projection vector is not too large can come automatically projection vector to be carried out to iteration adjustment with algorithm by corresponding image guidance system (and/or alternative conduit 200) and easily solve.If parameter d p23 changes to increase according to projected angle, this is an improvement.If parameter d p23 changes and reduces according to projected angle, should produce contrary angle and change.
The operation of alternative conduit 200 is automatization further.For example,, even if measurement and reconstruction processor 44a also can determine da23 < da12 under the maximum compression of spring 222.In the case, measurement and reconstruction processor 44a can make parameter d p23 correspondence between them, have the labelling pair of beeline, and longest distance is between the 1st labelling M1 and the 3rd labelling M3.This will make conduit image guidance system can easily determine each labelling M1, the identity of M2 and M3.
Note, had the patent of the ablation catheter that adopts certain type of spring in catheter tip.In a patent, the name of authorizing the people such as Goldenberg is called the U.S. Patent Bulletin 2010/0121269 of " Apparatus and method for sensing force on a robotically controlled medical instrument ", and spring is attached in the sensor in tip.In the name of authorizing the people such as Paul, be called in the United States Patent (USP) 7,311,704 of " Spring-tip, flexible electrode catheter for tissue ablation ", the spring relating to is as the part being more integrated of the actual ablating electrode at place, tip.The United States Patent (USP) 5 that is called " Endocardial catheter tor mapping and/or ablation with an expandable basket structure having means for providing selective reinforcement and pressure sensing mechanism for use therewith; and method " in the name of authorizing Imran, 255, in 679, the spring relating to transmits back joystick by contact force.In significant contrast, the invention provides a kind of catheter tip, it is suitable for having the deflection that detects the spring being associated by imaging technique, and makes deflection convert the estimation of most advanced and sophisticated contact force to.
It is also noted that, the invention provides except described those some other advantages.For example, for corresponding conduit system, do not need additional sensor or the cable being associated or fiber.In addition, power is stored in compressible most advanced and sophisticated spring, has guaranteed that contact force keeps more consistent when conduit and patient's anatomical tissue both moves, and has reduced the loss of contact force.At the excessive device that can cause excessive contact force and possible patient injury (for example, conduit) or in the event that moves of anatomical tissue, compressible tip will, as bolster, be decreased to contact force to a certain degree (by moving in order to absorb the spring-compressed of some excessive contact forces) effectively.The present invention also can be attached in the system of using optical fiber or other this type of force transducer, as standby power, measures or secondary force measurement, and this can be particularly useful for the high risk system with excessive power, as medical treatment gets involved robot system.
Other remodeling is possible in scope of the present invention.For example, under test patient to be scanned can be mankind subject, animal subject or any other applicable object.The alternative design that in addition, can exist the compressible catheter tip 14 that can be used by the present invention and/or the spring 22 that is associated to form.In addition, other medical treatment with power sensing demand that the present invention also can be used for except cardiac EP field gets involved application, and the non-medical use with power sensing demand.
In addition, in the further automatization of the operation of alternative conduit 200, measure and reconstruction processor 44a even also can determine da23 > da12 under the maximum compression of spring 222.In the case, measurement and reconstruction processor 44a can make parameter d p12 correspondence have the labelling pair of beeline therebetween.
In addition, although the step of method 100 has been described with certain order, the order of step can partially or even wholly rearrange, and step can appropriate change, supplement or omit.In addition, method 100 can with various known algorithms and software application performs step and sub-step.In addition, method 100 can be implemented with many algorithms and software application.In addition, method 100 can be by the step of adding or technique complementary.It is to be further understood that method 100 can with real time data, come from data archival or data base storage data, come from the data of On Remote Computer Network or the mixing of data source carry out in steps or any step.
In addition, various described equipment and instrument can be as required or are constructed like that as expected and interconnect.In addition, although in described method 100, user can be used self-contained equipment and instrument, but user can use combination or substitute for any step of method 100 or institute's described equipment and instrument use in steps, comprises those that can obtain by radio communication mode.In addition, described method 100 or any step can or utilize some manual interventions automatically to carry out by applicable equipment and instrument.

Claims (21)

1. a conduit, comprises the compressible catheter tip with a plurality of labellings, and described labelling is suitable for allowing the image guidance system being associated to follow the trail of described labelling to obtain the positional information of described labelling, and the contact force of estimating described tip from described positional information.
2. conduit according to claim 1, is characterized in that, the contact force at described tip is estimated in the deflection that the image guidance system being associated described in described labelling is suitable for allowing is measured described tip.
3. conduit according to claim 1, it is characterized in that, described compressible catheter tip also has the Compress Spring being attached to wherein, and the contact force at described tip is estimated in the deflection that the image guidance system being associated described in described labelling is suitable for allowing is measured described Compress Spring.
4. conduit according to claim 1, is characterized in that, described labelling comprises the magnetic resonance tracking coil in the structure that is attached to described tip.
5. conduit according to claim 1, it is characterized in that, described labelling comprises the magnetic resonance tracking coil in the structure that is attached to described tip, and described image guidance system is carried out the 3D positional information that nuclear magnetic resonance is followed the trail of described coil and obtained described coil.
6. conduit according to claim 1, is characterized in that, described labelling comprises the passive marker on the outer surface at described tip.
7. conduit according to claim 1, is characterized in that, described labelling comprises the passive marker on the outer surface at described tip, and described image guidance system is carried out the 2D positional information that projection imaging is followed the trail of described labelling and obtained described labelling.
8. a system that combines conduit system and image guidance system, comprise the compressible catheter tip with a plurality of labellings, described labelling provides the location of described catheter tip to come for by the visual of imaging guidance system with navigate, and provides the measurement of deflection of described catheter tip for estimating most advanced and sophisticated contact force by described imaging guidance system.
9. system according to claim 8, is characterized in that, described labelling comprises that described image guidance system comprises magnetic resonance imaging system by the magnetic resonance tracking coil of the structure combination of described catheter tip.
10. system according to claim 8, it is characterized in that, described compressible catheter tip comprises and is connected to slidably two sections going up each other and have respectively magnetic resonance tracking coil, and be connected to the Compress Spring between described two sections, described image guidance system is derived 3D coordinate from tracking coil signal, to determine the distance between described two coils, and estimate most advanced and sophisticated contact force from the decrement of described spring.
11. systems according to claim 8, is characterized in that, described labelling comprises the passive marker on the outside of described catheter tip, and described image guidance system is carried out projection imaging.
12. systems according to claim 8, it is characterized in that, described compressible catheter tip comprises and is connected to slidably two sections going up each other and have respectively at least one passive marker in respective surfaces, and be connected to the Compress Spring between described two sections, described image guidance system is derived 2D coordinate to determine the distance between described two labellings from described passive marker, and estimates most advanced and sophisticated contact force from the decrement of described spring.
13. systems according to claim 8, it is characterized in that, described compressible catheter tip comprises and is connected to slidably two sections going up each other, a section has passive marker in respective surfaces, another section has at least two passive markers in respective surfaces, also comprise the Compress Spring being connected between described two sections, described image guidance system is derived 2D coordinate from described passive marker and is determined a labelling section and the distance between the labelling on another section, and estimates most advanced and sophisticated contact force from the decrement of described spring.
14. systems according to claim 13, is characterized in that, at least two passive markers on described another section have accordingly between corresponding fixing and predetermined distance.
The method of the contact force that 15. 1 kinds of measuring guide tips apply destination object, is included in described catheter tip operating period to derive each the corresponding position coordinates in a plurality of labellings on described catheter tip; In the operating period of described catheter tip, determine the corresponding distance between labelling; And calculating the contact force of described tip to described destination object, described conduit is suitable for providing the variable distance between at least two in a plurality of labellings in described catheter tip operating period.
16. methods according to claim 15, it is characterized in that, described conduit is included in described catheter tip operating period provides the Compress Spring being associated of the described variable range between at least two in described a plurality of labelling, and described calculation procedure comprises based on spring property calculates the contact force of described tip to described destination object.
17. methods according to claim 15, is characterized in that, described derivation step comprises from the real-time positioning of the nuclear magnetic resonance of described catheter tip and described labelling and visual each the corresponding 3D coordinate obtaining described a plurality of labelling.
18. methods according to claim 15, is characterized in that, described derivation step comprises from the real-time positioning of the projection imaging of described catheter tip and described labelling and visual each the corresponding 2D coordinate obtaining described a plurality of labelling.
The method of the magnetic resonance of 19. 1 kinds of medical science intervene operations (MR) imaging guiding, comprise that positioning combination is at the MR tracking coil of the conduit for corresponding operation, and during the MR image viewing that checks patient's anatomical tissue from the power at locating information measuring guide tip.
20. methods according to claim 19, is characterized in that, described conduit is suitable for providing at least two variable distances between described MR tracking coil at corresponding intra-operative.
21. methods according to claim 19, is characterized in that, described method also comprises to corresponding operation provides power measured value, and it is in conjunction with the information of the credibility about locating information, to give the indication of the accuracy of the measured value of exerting oneself.
CN201310292907.5A 2012-07-12 2013-07-12 Compressible catheter tip with the power sensing based on image Active CN103536353B (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/547397 2012-07-12
US13/547,397 US10213130B2 (en) 2012-07-12 2012-07-12 Compressable catheter tip with image-based force sensing

Publications (2)

Publication Number Publication Date
CN103536353A true CN103536353A (en) 2014-01-29
CN103536353B CN103536353B (en) 2017-08-15

Family

ID=49914560

Family Applications (1)

Application Number Title Priority Date Filing Date
CN201310292907.5A Active CN103536353B (en) 2012-07-12 2013-07-12 Compressible catheter tip with the power sensing based on image

Country Status (2)

Country Link
US (1) US10213130B2 (en)
CN (1) CN103536353B (en)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106901719A (en) * 2015-12-22 2017-06-30 韦伯斯特生物官能(以色列)有限公司 For making the registration between the visual coordinate system of instrument
CN106913332A (en) * 2015-12-22 2017-07-04 韦伯斯特生物官能(以色列)有限公司 Find out position and be orientated so that instrument is visualized
CN110248592A (en) * 2017-02-03 2019-09-17 财团法人峨山社会福祉财团 Utilize the cardiac three-dimensional Mapping System and method of the heat transfer agent of conduit

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP6042023B2 (en) 2013-03-15 2016-12-14 セント・ジュード・メディカル・エイトリアル・フィブリレーション・ディヴィジョン・インコーポレーテッド Force sensing ablation catheter
CN107437469B (en) * 2016-05-27 2020-04-14 富泰华工业（深圳）有限公司 Pressing component
US20170347914A1 (en) 2016-06-01 2017-12-07 Becton, Dickinson And Company Invasive Medical Devices Including Magnetic Region And Systems And Methods
US11826522B2 (en) * 2016-06-01 2023-11-28 Becton, Dickinson And Company Medical devices, systems and methods utilizing permanent magnet and magnetizable feature
US20180000542A1 (en) * 2016-07-02 2018-01-04 St. Jude Medical, Cardiology Division, Inc. Flexible electrode
US10032552B2 (en) 2016-08-30 2018-07-24 Becton, Dickinson And Company Cover for tissue penetrating device with integrated magnets and magnetic shielding
JP7057354B2 (en) * 2016-10-11 2022-04-19 アクタス メディカル インク Ablation system for force control
US10660574B2 (en) 2017-03-08 2020-05-26 Biosense Webster (Israel) Ltd. Low cost planar spring for force sensor
US11317965B2 (en) 2017-03-08 2022-05-03 Biosense Webster (Israel) Ltd. Reduced size force sensor

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050165301A1 (en) * 2004-01-23 2005-07-28 Smith Scott R. Medical devices visible by magnetic resonance imaging
CN101416874A (en) * 2007-10-08 2009-04-29 韦伯斯特生物官能公司 Catheter with pressure sensing
US20090171196A1 (en) * 2007-12-31 2009-07-02 Olson Eric S Method and apparatus for encoding interventional devices
US20100312095A1 (en) * 2009-06-08 2010-12-09 Jenkins Kimble L Mri-guided surgical systems with proximity alerts

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5211165A (en) 1991-09-03 1993-05-18 General Electric Company Tracking system to follow the position and orientation of a device with radiofrequency field gradients
US5255679A (en) 1992-06-02 1993-10-26 Cardiac Pathways Corporation Endocardial catheter for mapping and/or ablation with an expandable basket structure having means for providing selective reinforcement and pressure sensing mechanism for use therewith, and method
US7311704B2 (en) 2004-05-27 2007-12-25 St. Jude Medical, Atrial Fibrillation Division, Inc. Spring-tip, flexible electrode catheter for tissue ablation
US20090076594A1 (en) * 2006-03-14 2009-03-19 Patrick Sabaria Method of monitoring positioning of polymer stents
US8478382B2 (en) * 2008-02-11 2013-07-02 C. R. Bard, Inc. Systems and methods for positioning a catheter
CN102196782B (en) * 2008-10-31 2014-04-30 皇家飞利浦电子股份有限公司 Method and system of electromagnetic tracking in a medical procedure
US8083691B2 (en) 2008-11-12 2011-12-27 Hansen Medical, Inc. Apparatus and method for sensing force
US9165114B2 (en) * 2010-03-11 2015-10-20 Koninklijke Philips N.V. Method and system for characterizing and visualizing electromagnetic tracking errors

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050165301A1 (en) * 2004-01-23 2005-07-28 Smith Scott R. Medical devices visible by magnetic resonance imaging
CN101416874A (en) * 2007-10-08 2009-04-29 韦伯斯特生物官能公司 Catheter with pressure sensing
US20090171196A1 (en) * 2007-12-31 2009-07-02 Olson Eric S Method and apparatus for encoding interventional devices
US20100312095A1 (en) * 2009-06-08 2010-12-09 Jenkins Kimble L Mri-guided surgical systems with proximity alerts

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
MARC REA ET AL: "System for 3-D real-time tracking of MRI-compatible device of image processing", 《IEEE ASME TRANSACTIONS ON MECHATRONICS》 *

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106901719A (en) * 2015-12-22 2017-06-30 韦伯斯特生物官能(以色列)有限公司 For making the registration between the visual coordinate system of instrument
CN106913332A (en) * 2015-12-22 2017-07-04 韦伯斯特生物官能(以色列)有限公司 Find out position and be orientated so that instrument is visualized
CN106913332B (en) * 2015-12-22 2021-11-26 韦伯斯特生物官能(以色列)有限公司 Ascertaining position and orientation to visualize tools
CN106901719B (en) * 2015-12-22 2022-03-08 韦伯斯特生物官能(以色列)有限公司 Registration between coordinate systems for visualizing tools
CN110248592A (en) * 2017-02-03 2019-09-17 财团法人峨山社会福祉财团 Utilize the cardiac three-dimensional Mapping System and method of the heat transfer agent of conduit
CN110248592B (en) * 2017-02-03 2022-05-31 财团法人峨山社会福祉财团 Heart three-dimensional mapping system and method using sensing information of catheter
US11439354B2 (en) 2017-02-03 2022-09-13 The Asan Foundation System and method for three-dimensionally mapping heart by using sensing information of catheter

Also Published As

Publication number Publication date
CN103536353B (en) 2017-08-15
US20140018665A1 (en) 2014-01-16
US10213130B2 (en) 2019-02-26

Similar Documents

Publication Publication Date Title
CN103536353A (en) Compressable catheter tip with image-based force sensing
US11382530B2 (en) Symmetric short contact force sensor with four coils
JP6914648B2 (en) Use of force sensors to give the angle of the ultrasonic beam
CN105559746B (en) Alignment map using intracardiac signals
US7720520B2 (en) Method and system for registering an image with a navigation reference catheter
EP1626660B1 (en) Systems for registering ultrasound image in three-dimensional coordinate system
EP2875780B1 (en) Tracking of catheter using impedance measurements
US20220125509A1 (en) Reduced size force sensor
CA2688743C (en) Catheter display showing tip angle and pressure
CN105286866B (en) The system and method for performing medical procedure
KR20190027326A (en) Mesh fitting algorithm
US20130282005A1 (en) Catheter navigation system
JP2017086913A5 (en)
CN103829942A (en) Using location and force measurements to estimate tissue thickness
US9820677B2 (en) Cointegration filter for a catheter navigation system
AU5338798A (en) Conformal catheter
EP3105561B2 (en) Temperature distribution determination apparatus
EP3578099B1 (en) Low cost planar spring for force sensor
CA3135773A1 (en) Systems and methods for performing localization within a body
EP2666411A1 (en) Position sensing using electric dipole fields
US20220020228A1 (en) Systems and methods for modifying geometry surface models using electrophysiology measurements
EP4205653A1 (en) Intuitive mapping system

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant